Ipsec implementation

Ipsec implementation There are many methods to IP Security. In the Microsofts Windows 2003 the server version, there are many such techniques and tweaks which are useful to help provide a secure base to the system. The operating system is very good in protecting the system from attacks which may be active attacks or in some cases passive attacks. The procedures for IPSec are placed properly into the system which helps it tackle such attacks. This is possible by providing a secure packet filter for packet transport and also using cryptography. This technology is very in high use for communication types like host to host, router to router, gateway to gateway, site to site and also in virtual private networks. Some other places for successful implementation are secure servers. The IPSec comes as a basic Group Policy controlled by Dos Prompt commands and it also has user interface with custom programs installed. The implementation of IPSec involves these steps: Overview of IPSec Deployment Determining Our Internet Protocol Security targets Preparing a Internet Protocol Security Policy Implementation of the designed policies Overview of IPSec Deployment: There are many techniques such as usage of cryptography and authentication software to secure the communication in a network. The connection may be between two parties or between a group of users. Security is to make sure that the communication is not broken, the communication is not intervened and the data is not altered. The Internet Protocol Security has some features which help running a secure transmission. IPSec has set procedures which help achieve these ends. Today there are many companies and it is getting harder day by day to ensure the security of such humungous networks with a heavy workload on the networks. It is also very hard to track any attacks on the network in millions and millions of request. Using firewalls to protect a network did work for some days but it has proved to be impractical as it has no proper rules to detect intrusions or attacks. The advent of IPSec is a leap in computer and network security. This protocol has a wide spectrum of features which are strong enough to contain such high volume of network requests and also handle intrusions. The Internet Protocol for Security is not a versatile detection protocol. It is capable of managing most of the policies to grant or reject, block and negotiate the traffic in a network. This can also be permitted to a specific set of addresses or in some cases protocol and also a different policy to each port. It is recommended that we use ICF (Internet Connection Firewall) when we are in need of a firewall which is capable of providing a network interface for very big networks. This is because the internet protocol for Security has a very strict and a very stern strategy which is based on static filtering based on IP addresses. But this is it is totally different in the case of the Internet Connection Firewall. The ICF has policies which has a set of filter for all the addresses which are capable of being accessed. The Internet Protocol for Security can be used when the restriction is only to a particular set of addresses or the communication between a group of computers. There are many ways to use IPSec in a network but the best way is bye using a directory with all the domains and also a GP when needed. Some areas of interest when implementing IPSecurity: The decision of where we must secure computers and how on our network which can be done by running a group of systems in a directory which is also called as the Active Directory Organisational Units or OUs. The next step is to determine the strength of the policies we assign. Determining Our Internet Protocol Security targets: The first step in deploying IPSec on our server or the network can be done properly by deciding which set of systems are in dire need of security. There are surely some places on the network which are in a need of higher security than the other sections. It is for sure that IPSec is capable of providing optimal security but the problems starts when the network slows down due to the excessive data to be processed and also a large number of systems for IPSec to follow and maintain. In some cases, there are systems which are not upgraded to be able to support the IPSecurity. Determining Your IPsec Needs In beginning of the protocol design procedure, proper planning should be done to make sure that our current network environment available for use. It is always helpful to have a set of the network topology with all of its hardware and software components. This procedure is of high importance mainly in the designing procedure. IPSecurity is highly vulnerable to a network topology. There are many network topologies in which IPSec is not well suited. Preparing a Internet Protocol Security Policy: As said earlier, there are many network topologies which are not suitable to the default structure of the IPSec policies. There is a need to develop a custom IPSec set of policies well suited for the current network. Some organisations can run their network with a small set of policies. But in companies with a very huge network, there are many policies which are to be implemented properly and also a stringent structure is to be maintained. Steps below shows how IP Sec policies work. Designing IPsec Policies There might be some cases where the company or the organisation is interested in implementing a policy which sets a secure communication between two specified computers. This can be done by restricting all traffic and adding exceptions which relates to these two systems. This method can be done vice versa. A network can be setup with policies to allow all requests and block specific ports or computers. To implement such exceptions, a thorough analysis of the network is clearly needed. Computer roles: Security for Data Transmission: Security needs are different from each and every data packet transmitted. The security policies are also very different. There are many levels in this instance. When considering encryption, there are many types such as AES, DE5, RSA and many more. RSA is the best encryption software available presently. These programs can be used to secure files on transmission, on a network or even in the system. Operating System Computers: IPSecurity is a very unique technique used to implement security in a network. There are many operating systems which are not so advanced to implement IPSec. There is no support for IPSec. But there are many operating systems which are capable of running IPSec in transport mode. Some other cases, the policies are stored locally which makes it easier to decide as the implementation doesnt take long enough. In some cases, IPSec policies are implemented through the Group Policy. General IPSec Policy Settings General IPSec policy settings must be specified whether we want the policy to provide packet filtering or end-to-end networks. IPSec Rules IPSec rules determine which traffic is affected by an IPSec policy and which actions take place when that type of traffic is encountered. Table6.5 describes the contents of IPSec rules that two computers use to establish a secure, authenticated channel. Specifies a named list of filters. Each filter in the filter list specifies the types of traffic to which the filter action is applied. Filters can be defined to match specific IP protocols, source and destination TCP and UDP ports, and source and destination IP addresses. The filter list name might include the version number, the last update time, and the administrative owner. Each computer discards the filter list name during policy processing. Filter action Specifies whether a packet is permitted, blocked, or secured. If packets are to be secured, specifies how they are secured. A list of security methods specifies the security protocol, cryptographic algorithm, and session key regeneration frequency. Request Security Authentication methods One or more authentication methods, which are specified in order of preference. Available options are KerberosV5, certificate, or preshared key. Specifies whether to use tunnel mode and, if so, the tunnels endpoint. Specifies whether the rule applies to LAN connections, remote access connections, or both. Assigning IPSec Policies: As a domain administrator, we can configure IPSec policies to meet the security requirements of a user, group, application, domain, site, or global enterprise from a domain controller. IPSec policy can also be implemented in a non-Windows2000-based domain environment by using local IPSec policies. Deploying Our IPSec Solution: After scoping our needs, building IPSec policies, and determining our strategy for assigning the policies to specific OUs, test the IPSec policies in a lab environment and conduct a pilot project before rolling them out for production use. To ensure that IPSec policy functions as expected and provides the appropriate level of security, test specific IPSec policy configurations on clients and servers in a lab environment, and then conduct pilot or beta tests in a limited operational environment before conducting a full-scale deployment. A Cryptographic Evaluation of IPsec: Even with all the serious critisisms that we have on IPsec, it is probably the best IP security protocol available at the moment. We have looked at other, functionally similar, protocols in the past (including PPTP [SM98, SM99]) in much the same manner as we have looked at IPsec. None of these protocols come anywhere near their target, but the others manage to miss the mark by a wider margin than IPsec. This difference is less significant from a security point of view; there are no points for getting security nearly right. From a marketing point of view, this is important. IPsec is the current best practice, no matter how badly that reects on our ability to create a good security standard. Our main criticism of IPsec is its complexity. IPsec contains too many options and too much exibility; there are often several ways of doing the same or similar things. This is a typical committee efiect. Committees are notorious for adding features, options, and additional exibility to satisfy various factions within the committee. As we all know, this additional complexity and bloat is seriously detrimental to a normal (functional) standard. However, it has a devastating efiect on a security standard. It is instructive to compare this to the approach taken by NIST for the development of AES [NIST97a, NIST97b]. Instead of a committee, NIST organized a contest. Several small groups each created their own proposal, and the process is limited to picking one of them. At the time of writing there has been one stage of elimination, and any one of the five remaining candidates will make a much better standard than any committee could ever have made. The Complexity Trap: Securitys worst enemy is complexity. Complexity of IPsec In our opinion, IPsec is too complex to be secure. The design obviously tries to support many difierent situations with difierent options. We feel very strongly that the resulting system is well beyond the level of complexity that can be analysed or properly implemented with current methodologies. Thus, no IPsec system will achieve the goal of providing a high level of security. IPsec has two modes of operation: transport mode and tunnel mode. There are two protocols: AH and ESP. AH provides authentication, ESP provides authentication, encryption, or both. This creates a lot of extra complexity: two machines that wish to authenticate a packet can use a total of four difierent modes: transport/AH, tunnel/AH, transport/ESP with NULL encryption, and tunnel/ESP with NULL encryption. The difierences between these options, both in functionality and performance, are minor. The documentation also makes it clear that under some circumstances it is envisioned to use two protocols: AH for the authentication and ESP for the encryption. Modes As far as we can determine, the functionality of tunnel mode is a superset of the functionality of transport mode. (From a network point of view, one can view tunnel mode as a special case of transport mode, but from a security point of view this is not the case.) The only advantage that we can see to transport mode is that it results in a somewhat smaller bandwidth overhead. However, the tunnel mode could be extended in a straightforward way with a specialized header-compression scheme that we will explain shortly. This would achieve virtually the same performance as transport mode without introducing an entirely new mode. We therefore recommend that transport mode be eliminated. Recommendation 1 Eliminate transport mode. Without any documented rationale, we do not know why IPsec has two modes. In our opinion it would require a very compelling argument to introduce a second major mode of operation. The extra cost of a second mode (in terms of added complexity and resulting loss of security) is huge, and it certainly should not be introduced without clearly documented reasons. Eliminating transport mode also eliminates the need to separate the machines on the network into the two categories of hosts and security gateways. The main distinction seems to be that security gateways may not use transport mode; without transport mode the distinction is no longer necessary. Protocols The functionality provided by the two protocols overlaps somewhat. AH provides authentication of the payload and the packet header, while ESP provides authentication and confidentiality of the payload. In transport mode, AH provides a stronger authentication than ESP can provide, as it also authenticates the IP header fields. One of the standard modes of operation would seem to be to use both AH and ESP in transport mode. In tunnel mode, ESP provides the same level of authentication (as the payload includes the original IP header), and AH is typically not combined with ESP [KA98c, section 4.5]. (Implementations are not required to support nested tunnels that would allow ESP and AH to both be used in tunnel mode.) One can question why the IP header fields are being authenticated at all. The authentication of the payload proves that it came from someone who knows the proper authentication key. That by itself should provide adequate information. The IP header fields are only used to get the data to the recipient, and should not afiect the interpretation of the packet. There might be a very good reason why the IP header fields need to be authenticated, but until somebody provides that reason the rationale remains unclear to us. The AH protocol [KA98a] authenticates the IP headers of the loour layers. This is a clear violation of the modularization of the protocol stack. It creates all kind of problems, as some header fields change in transit. As a result, the AH protocol needs to be aware of all data formats used at loour layers so that these mutable fields can be avoided. This is a very ugly construction, and one that will create more problems when future extensions to the IP protocol are made that create new fields that the AH protocol is not aware of. Also, as some header fields are not authenticated, the receiving application still cannot rely on the entire packet. To fully understand the authentication provided by AH, an application needs to take into account the same complex IP header parsing rules that AH uses. The complex definition of the functionality that AH provides can easily lead to security-relevant errors. The tunnel/ESP authentication avoids this problem, but uses more bandwidth. The extra bandwidth requirement can be reduced by a simple specialized compression scheme: for some suitably chosen set of IP header fields X, a single bit in the ESP header indicates whether the X fields in the inner IP header are identical to the corresponding fields in the outer header.2 The fields in question are then removed to reduce the payload size. This compression should be applied after computing the authentication but before any encryption. The authentication is thus still computed on the entire original packet. The receiver reconstitutes the original packet using the outer header fields, and verifies the authentication. A suitable choice of the set of header fields X allows tunnel/ESP to achieve virtually the same low message expansion as transport/AH. We conclude that eliminating transport mode allows the elimination of the AH protocol as well, without loss of functionality. We therefore recommend that the AH protocol be eliminated. IPSEC methodology using different operating systems: IPSEC is a framework for security that operates at the Network Layer by extending the IP packet header. This gives it the ability to encrypt any higher layer protocol, including TCP and UDP sessions, so it offers the greatest flexibility of all the existing TCP/IP cryptosystems. While conceptually simple, setting up IPSEC is much more complex that installing SSH, for example. IPSEC also has the disadvantage of requiring operating system support, since most O/S kernels dont allow direct manipulation of IP headers. Linux IPSEC support (the FreeS/WAN project), for example, isnt included in the standard kernel distribution for this reason, and has to be applied as an add-on. Furthermore, putting the cryptography in the kernel isolates it from the application, making it more difficult to code crypto-aware software. Using SSL, for example, simply requires linking a library into the application and allows the application to easily query what certificates have been used to authenticate a client. IPSEC defines a Security Association (SA) as its primitive means of protecting IP packets. An SA is defined by the packets destination IP address and a 32-bit Security Parameter Index (SPI), that functions somewhat like a TCP or UDP port number. SAs can operate in transport mode, where the IPSEC data field begins with upper level packet headers (usually TCP, UDP, or ICMP), or in tunnel mode, where the IPSEC data field begins with an entirely new IP packet header, ala RFC 2003. Furthermore, SAs can be encapsulated within SAs, forming SA bundles, allowing layered IPSEC protection. For example, one SA might protect all traffic through a gateway, while another SA would protect all traffic to a particular host. The packets finally routed across the network would be encapsulated in an SA bundle consisting of both SAs. A common use of IPSEC is the construction of a Virtual Private Network (VPN), where multiple segments of a private network are linked over a public network using encrypted tunnels. This allows applications on the private network to communicate securely without any local cryptographic support, since the VPN routers perform the encryption and decryption. IPSEC is well suited for this environment, more so than tunneling PPP over SSL or SSH, since it operates directly on the IP packets and preserves a one-to-one correspondence between packets inside and outside the network. In the case of tunneling PPP over an encrypted TCP connection, any packet loss in the public network would trigger a TCP retransmission, stalling the link until the packet was delivered. In particular, running Voice Over IP (VoIP) traffic through a TCP/PPP tunnel would largely defeat the RTP protocol used for VoIP; IPSEC is better suited in this case. IPsec Development for Linux: In the Linux IPv4 IPsec world, a lot of people use FreeS/WAN projects implementation. It consists of an inkernel IPsec processing part, Key Exchange daemon Pluto and some utility commands/scripts. To run Pluto with small changes on our IPsec kernel implementation and reduce impact for user who use FreeS/WAN implementation, we have decided to keep compatibility with FreeS/WANs IPsec programming interface between kernel and userland. For this, we use the same PF KEY interface which FreeS/WAN project extended. In kernel IPsec packet processing part, we developed AH, ESP, SAD and SPD from scratch. PF KEY interface PF KEY(v2), which is described in RFC2367, is key management API mainly for IPsec. PF KEY is used for handling the IPsec Security Association Database. Additionally we have to handle the IPsec Security Policy Database, but there is no standard for the IPsec Security Policy management API. In FreeS/WAN implementation, PF KEY interface is extended to manage the IPsec Security Policy Database. Our kernel 2.4 IPsec implementation also uses the same PF KEY interface as FreeS/WANs one. It is important to be able to run the FreeS/WANs userland application (e.g., Pluto) with small changes. Encryption and Authentication algorithm We provide HMAC-SHA1 and HMAC-MD5 for authentication, NULL, DES-CBC, 3DES-CBS and AES for encryption. We thought encryption and authentication algorithm is not only used by IPsec and there are many algorithms so that we consider encryption and authentication algorithm and those interface should have good modularity. We adopted cipher modules which provided by CryptoAPI Project. Security Association and Security Policy SA and SP themselves dont depend substantially on the IP version. FreeS/WAN project architecture depends on their special virtual network interface for IPsec because it might focus on IPv4 tunnel mode (Their implementation also provides IPv4 transport mode). Their SA, SP, SAD and SPD also depend on their special virtual network interface. We considered and decided it was not suit to IPv6 because the IPv6 stack needed the neighbor discovery and the auto address configuration in its basic specification. If we had implemented IPv6 IPsec stack with their architecture, we had to implement those basic specification in their special virtual network interface. Therefore we implemented our own SAD and SPD in order to handle both IPv4 and IPv6. To improve the system performance, Each database will be locked by smallest granularity. And in many cases we use the read lock. SA and SP are managed by the reference counter to prevent used SA from removing by accident. IPsec Packet Processing Output There are various packet output paths from the IP(v4/6) layer to the network driver layer in Linux kernel networking stack (TCP, UDP/ICMP, and NDP[10] for IPv6). The packets which may be applied IPsec will go through these paths. We had to add IPsec functionality for these output paths, e.g, in IPv6 ip6 xmit() for TCP, ip6 build xmit() for UDP/ICMP and ndisc send ns()/ndisc send rs() for neighbor discovery packets. Output process is as follows): check IPsec SP lookup the IPsec SA by the IPsec SP apply IPsec processing to the packet output the packet to the network driver layer To reduce SA searhing time, we link the SP and the found SA after lookup from the first time. Input At input, there is only path for IP packets. We added IPsec processing part in ip6 input finish. Input process is as follows: receive the packet lookup the IPsec SA by SPI(which resides in AH/ESP header) check integrity and decrypt check IPsec Policy. IPsec Tunnel mode We are using IPv6-over-IPv6(and IPv4-over-IPv4) virtual tunnel device to implement IPsec tunnel mode. This implementation can avoid to duplication code of encapsulation/ decapsulation outer IP header compairing with having these code in the IPsec processing part itself. The virtual tunnel device is not different from the normal IP-over-IP virtual tunnel device in Linux. 4 IPsec implementation for kernel 2.6 The most important difference between ours and them is SAD/SPD part. They thought the whole SPD/SAD mechanic should be flow cache based lookup system shared by IPv4 and IPv6. One month later, they introduced the new network architecture called XFRM to Linux kernel 2.5. At first their developing code lacked IPv6 IPsec only for IPv4 IPsec. In order to suport IPv6 IPsec, we have implemented IPv6 IPsec code based on XFRM (and discarded our original code). PF KEY interface The PF KEY interface of Linux kernel 2.6(and 2.5) is compatible with KAME[3] PF KEY interface. We can use setkey command for configuring SA and SP and Racoon for IKE. Additionally we can add IPsec Policy each socket via Netlink3. They have suported only IPv4 in their first code, we have added IPv6 support. Security Association and Security Policy On the XFRM architecture, IPsec SP, which is represented as xfrm policy structure, will be bound to the routing flow cache (and IPsec policy will point IPsec SA bundle) and IPsec SA, which is represented as xfrm state structure, is included in destination cache, dst entry structure. The chaining destination cache means IPsec SA bundle. IPsec Packet Processing Output The output part of the XFRM architecture is placed between the IP layer and the network driver layer. In general, non IPsec packet will be passed to the network driver layer by a single destination output function, which is resolved routing lookup. But IPsec packet will be need to apply some IPsec processing (e.g., encryption, hash). XFRM functions make a chain of destination output functions (We call Stackable Destination, as shown in Figure3). Each function match each IPsec processing (AH, ESP and IPcomp[11]). To be more specific, in order to pass a packet to the network driver layer we have to do as follows. lookup routing table to decide output function by ip6 route output lookup IPsec Security Policy lookup IPsec Security Association(s) suitable for IPsec Security Policy and create destination chain to apply IPsec, pass a packet to the destination chain Input The input part of the XFRM architecture is simpler than output. The XFRM input function is handled as same as upper layer protocols like TCP, UDP, etc. In IPv6, IPsec headers are defined as IPv6 extension header but IPsec input functions are handled as an upper layer protocol handler. As the result of introducing IPv6 IPsec input processing in Linux. kernel, inconsistencies existed between IPsec headers and other IPv6 extension headers. In order to resolve this, we moved to the other IPv6 extension header handler functions to upper layer protocol handler. In detail, we registered IPsec header (both AH and ESP) handler functions with upper layer protocol handler array inet6 protos. Incoming IPsec packet processing flow is as follows: process IP packet from IP header in sequence process IPsec part (check integrity and decrypt) if founded check IPsec Security Policy pass IP packet next handler IPsec Tunnel mode Linux kernel 2.6 IPsec tunnel mode doesnt use the virtual tunnel device to create tunnel. The IPsec stack builds the outer IP header during IPsec processing by itself. IPSec Best practices Best practices IPSEC in transport mode has some serious advantages over other solutions. Compared to other technologies, IPSEC is built into to the Linux kernel. In other words there is nodaemonrunning in the background. Better yet, IPSEC does not require port-forwarding; some people elect to useSSH, stunnel, and other technologies that rely onport forwarding. With IPSEC, you simply have to run a program and its configuration file. After running it,encryptionbetween hosts is mandatory. Connections will be refused if the other connection does not have the appropriate keys. Groups of computers can share the same key, and it can even be done on a per-port setting (for example securing VNC, etc). Downsides? IPSEC in transport mode does have a couple draw backs. In transport mode you cannot have any dynamic setups where the IP addresses change from time to time. In other words, IPSEC is usually insufficient for workstation environments or dynamically assigned networks. Also, if you want to do a per-port setup the configuration becomes harder. Security Implications A very astute user can use IPSEC to bypass firewalls and other security measures. Since IPSEC uses cryptography, information is passed between machines in encrypted format. If the keys are not known, there is no practical way to decrypt the information (it is virtual impossible due to the sheer amount of time it would take). Machine-to-Machine IPSEC installations should be considered as Virtual Private Networks (VPNs) for security considerations. Please check with yoursystem administrator, business policies, and laws and regulations of your locality in order to establish whether or not to institute IPSEC. Requirements ipsec-tools package static IP addresses for each machine Configuration file The configuration file, /etc/setkey.conf, contains the information about the IPSECpolicy. Below is a sampleconfiguration policy(i.e. dont implement this policy because it is insecure). These lines are the actual keys and the encryption that will be used. The first block has the keys that will be used for authentication. In this case, it is the hmac-md5algorithm. The second block contains the keys that will be used for privacy, and the method of encryption. In the example, AES-CBC will be used, which is probably stronger than should be required; the key that we will be using is 194bits, meaning that it is good enough for US Government Secret and below classifications. The final block includes the actual policy. This is where you can put port numbers and even define whether it will be TCP orUDP. Generating the keys The more random the key, the better. Obviously, the example above is insufficient to secure a network. The following command will generate a random key. While running this command, youll need to wiggle the mouse to make it run faster. Or, if you are using a terminal use/dev/urandom instead. dd if=/dev/random count=16 bs=1| xxd -ps Depending on the size of the key that you want, adjust the count (16 will produce a 128 bit key, 24 will produce a 196 bit key, and 32 will produce a 512 bit key) The size of the key is important. If you really paranoid or just haveCPUcycles to

Persuasive Essay: The Holocaust :: Persuasive Writing

My reaction to the Holocaust was devastating. It is one example of bad things happening to good people. The mass murdering of so many Jews is just disgusting and also because it was done for basically no reason. As this was a true event many sources or witnesses are available to express their views, feelings and emotions of themselves and those who survived this terrible tragedy. I will demonstrate examples of Jews who have survived what they have been through and what they think about God. It is really hard to go through all of this and still believe that God exists. The holocaust should not change our theology on God. It is said to be that the Holocaust was a temporary "Eclipse of God".[1] This is supposed to be when God is away from earth beyond any reason or explanation. People trying to respond to this problem of believing that there is a God after witnessing the terrible event have either succeeded or failed. I will introduce three people who have survived the Holocaust and have tried responding to this problem. The three people included are Primo Levi, Richard Rubenstein and Emil Fackenheim. I think a big impact on the life of Jews would be their belief in God because many of them have tried responding to this problem and have changed the ways in which they think about him, their views on how good or powerful he is, how they express him and why they still believe in him. I will introduce the problem of evil to the Jews that have survived the Holocaust and their problems of belief. I will also say which of the three Jews the most are convincing to me. The holocaust presents a problem for the Jews and changes their belief in God because now some Jews think "God is Dead" [2] Their reason to thinking this is because God is supposed to be omnipotent and almighty he could not have let something like this to happen. If there was a God, surely this event would not have taken place.

Wounds, Meds and Complex Care in Nursing Practice

1. The preoperative checklist on what needs to be done to take care of a patient can be found on the patient’s chart, usually under the doctor’s orders and/or the patient’s notes. 2. The National Institute for Clinical Excellence recommends that blood tests should be taken prior to having a surgery regardless of patient’s healthy condition, unless contraindicated. This is done to provide information about conditions that could affect the treatment that a patient would need (Lab Tests Online, 2004). Blood tests to be included in this routine preoperative testing are a full blood count, blood clotting tests, blood typing, blood gasses, blood glucose, and a sickle cell test (Lab Tests Online, 2004). A full blood count will measure haemoglobin and the number of other types of cells in the blood (Lab Tests Online, 2004). Blood typing is for blood transfusion, in case needed. Blood clotting test to determine if blood clots normally and how long it takes to clot (Lab Tests Online, 2004). Blood gasses, measures the amount of oxygen and carbon dioxide in the blood, as well as its acidity, and blood glucose to check for diabetes. Sickle cell testing if the patient has risk factors. 3. The registered nurse is responsible for reporting any discrepancies in the lab results of the patient to the physician in charge. 4. Preoperative education should include orienting the patient with the surgery that she is going to go through. Ask what she understood from the physician and answer her questions for further clarification. Afterwards, explain the patient what to expect during her recovery period, and what are her postoperative exercises. Also, enlighten the patient on the risks of post-op recovery like pulmonary embolus, DVT and UTI, and the possible ways on how to avoid these, through deep breathing exercises and wearing of anti-embolic stockings (University of South Australia, 2000). Finally, inform her of what other procedures are to be done after the surgery, for example, utilization of catheters and IV therapy. 5. A preoperative shower employs the use of a 2% chlorhexidine gluconate polyester cloth in scrubbing the patient’s body as a preventive preparation aimed at reducing the patient's skin colonization before the incision is made (Bjerke, 2001). . The anaesthesiologist is the one to administer the anaesthesia. 7. A general anaesthesia will make Mary unaware of what is happening during the operation, it will make her not feel anything, it will even put her to sleep (Rashiq, 2007). Penthidine is the analgesic of choice postoperative; to not feel pain (JBC Handbook, 1997). 8. An epidural anaesthesia is called an epidural block and requires the injection of anaesthetics in the epidural membrane that surrounds the spinal cord (Sarafino, 2006). Epidural blocks are most commonly administered during labour and delivery (American Pregnancy Association, 2007). . Marking the legs preoperative is done traditionally by estimating the position of the hip joint by palpation of the greater trochanter (The, 2006). 10. Epidural infection, nerve damage, backache, headache and urinary retention (Faure, 2000). 11. a. Ensure patient’s tag is the same with her chart. b. make sure patient is not wearing any metals, jewelleries, etc. c. ensure is certain about undergoing the operation d. ensure that patient has gone through all the necessary diagnostic tests e. ensure that patient is still on NPO. 12. The patient’s chart, diagnostic test results, patient’s consent. 13. Vital sign assessment has to be done every 15 minutes for the first hour and special attention will be brought to the patient’s respiration, due to the anaesthesia, and circulation and sensation of the extremities especially in the affected areas. Output is also monitored. Patient still on NPO until anaesthesia wears off totally. 14. No, this is a common postoperative effect. Continue monitoring output. 15. Decrease in urine output is common postoperative due to opioid drugs, immobility, and decreased oral intake (Merck, 2005). The physician may order Crede’s manoeuvre to be implemented and Betanechol can be administered (Merck, 2005). 6. Neurovascular checks are important to determine if there was nerve damage or internal bleeding and a circulation problem, or even infection, which could have been caused by the surgery. The neurovascular check is comprised of the five P’s, namely pain, paralysis, paraesthesia, pulses, and pallor (Judge, 2007). Check for thes e in the patient’s limbs. 17. Loss of pedal pulses might mean lack of arterial flow (Judge, 2007). This should be reported immediately to the registered nurse or the physician, whoever is readily available. 18. Any deviation from the normal baseline data regarding neurovascular checks should be reported immediately to the physician to avoid amputation of the affected extremity. 19. Log roll patient with abductor hip in place. To prepare the patient, she should be placed on one side of the bed, and rolled like a log to the unaffected side of the hip replacement. 20. A postoperative wash will make the patient feel comfortable and refreshed, also it will minimize infection. 21. Her pain might increase or decrease and this can signal a change in the source of pain. Also, the narcotic’s infusion rate can be changed if pain is lessened. 2. Two or more nurses to ensure that the correct rate is delivered. 23. As a student nurse, I cannot change infusion rates for narcotic pain relievers because I do not have the license yet that will make me accountable for any unpleasant consequence that might arise from the situation. Even under the watchful eye of my instructor, I cannot do it. 24. Na rcotics have to be watched for their side effects, especially respiratory depression. Observations that can be noted when a patient is with a narcotics infusion include clients respiratory rate, confusion and drowsiness (BP Cancer Agency, 2008). 5. Heparin injections are administered as a prophylaxis for blood clots (Science News, 1988). 26. Bleeding can be a complication of heparin use because it prevents clotting. Be wary of the following signs: black, tarry stools and bleeding from gums when brushing or flossing teeth, continued redness or pain after an injection, nosebleeds, red urine, unusual bruising coughing up blood (Drug Information Online, 2008). 27. Positive nitrate may indicate bacterial contamination, and traces of protein and blood are not alarming (Eccles Health Sciences Library, 2008). 28. Yes. This is because catheter removal will help in eradicating any possible bacterial contamination. 29. A urine specimen should be sent for a culture and sensitivity test to determine what bacteria is infecting the patient’s urinary tract. Sample should be sent to the laboratory immediately. 30. The needed equipment shall be gathered. After washing one’s hands and explaining to the patient what procedure is to be done and what the rationale behind it is, the drainage tubing directly below the aspiration port will be clamped with a rubber band or clamp (Integrated Publishing, 2007). This is to ensure that an adequate amount of urine for a specimen can be taken. A syringe will be used to aspirate the urine specimen. After gathering enough urine, the clamp shall be removed. 31. Inserting an indwelling catheter requires that the equipment needed be gathered first. Then the procedure is to be explained to the patient. She should be placed in a dorsal recumbent position. Using the sterile technique, the patient should be draped with sterile dressings. Sterile gloves will then be worn. Catheter tip is to be lubricated and placed on the sterile catheter tray. The labia are to be separated with the thumb and forefinger and a swipe of a swab with sterile povidone-iodine shall be done from the meatus toward the rectum. This shall be done thrice discarding each swab after one swipe. Catheter is to be inserted two to three inches into the urethra, and an additional inch once there is urine flowing. Balloon will be inflated once it is inside the bladder. Traction is gently applied to the catheter and drainage is taped to Mary’s thigh. (Kaplan, 2007) 32. To remove an indwelling catheter, a small syringe is attached to the inflation port on the side of the catheter and all the fluid is drawn out (Moore et al, 2007). Afterwards, slowly pull the catheter out (Moore et al, 2007). 33. Patients are on strict monitoring of fluid balance because they are receiving fluids through their IV therapies and postoperative patients are still weaning off from their anaesthesia, making urine retention a side effect. A positive fluid balance occurs when intake is greater than output, and a negative fluid balance happens when intake is lesser than output. 34. Fluid overload can bring about fluid and electrolyte imbalance, dysrhythmia, high blood pressure, non-pitting oedema, diarrhoea, projectile vomiting, among many others (Williams, 2008). Osmotic diuretics can be administered per doctor’s orders, patient should be on strict I&O, IV fluids should be checked hourly, fluids should be restricted (Williams, 2008). 35. The medications should also be reflected on the output of Mary if it is working. 36. total intake: 500ml IVF + 2160 ml tea and Milo + 360ml water = 3020 total output: 1400ml urination + bowel The patient is in a positive balance.

Uncountable Noun Definition and Examples

An uncountable noun  is exactly what it sounds like:  a noun that refers to things that normally are not or cannot be  counted. An uncountable noun is called a  Nombre incontable  or  sustantivo incontable  in Spanish, and sometimes known as a mass noun, non-count noun or partitive noun in English. How Do Uncountable Nouns Work? One example of an uncountable noun is courage, or  coraje in Spanish—you cant say one courage, two courages, three courages, and so forth in English, and you cant do it in Spanish either. Normally, this word exists in the singular form only. It is possible to quantify such a noun by using a lot of or much (mucho in Spanish), as in He has a lot of courage (Tiene mucho valor). It is also possible to quantify some uncountable nouns by using a measurement followed by of (de in Spanish), such as in a liter of milk (un litro de leche).   What Kinds of Nouns Are Usually Uncountable? Common types of uncountable nouns include personal qualities (such as thoughtfulness or  consideracià ³n), liquids (such as coffee or  cafà ©), and abstractions (justice or  justicia). Uncountable Nouns that Are Countable Sometimes Some nouns are countable or uncountable  depending on how they are used. For example, in normal usage, salt (sal) is uncountable. But a chemist might talk about different types of metallic salts (sales metà ¡licas), in which case the word is being used as a countable noun. Uncountable Nouns Dont Usually Need an Article In Spanish, the grammatical significance of uncountable nouns is that they generally are not preceded by an article when talking about a portion. Example: Necesito sal. (I need salt.) The speaker doesnt need all the salt, just a portion. Other examples: Bebà ­an leche (They drank milk.) and Compraramos gasolina (We will buy gasoline.) Examples of Uncountable Nouns in Sentences Here are some more examples of how uncountable nouns may be used in Spanish: La  luz  se propaga in todas direcciones.  (The  light  propagates in all directions.)Comprà © dos libras de  azà ºcar.  (I bought two pounds of  sugar.)La  fidelidad  matrimonial no tiene que ser un sueà ±o.  (Marital  faithfulness  doesnt have to be a dream.)

The Death Of The Modern American Mafia - 1532 Words

The American underworld reared its head for the first time in the late nineteenth century. Since this time new waves of immigrants to the United States, primarily Italian, have facilitated in the rise of organized crime in America. Italian mafia members treated the workings in America as an extension of the Sicilian mafia rather than a new organization. The immigration of the Lucania family from Italy to the United States would be the cause of one of the most drastic changes in the workings of organized crime. Charles Luciano became the father of the modern American mafia. Charles Luciano lived the hard childhood experienced by the children of almost all immigrants. On November 24, 1897, Charles Luciano, christened Salvatore Lucania, was†¦show more content†¦Luciano could barely speak English which caused him to struggle in school and, being stubborn and belligerent, he turned to the streets (Gosch, 1975). However, during his five years of formal education, Luciano did learn one thing: Jews could prove extraordinary allies (Gosch, 1975). Luciano learned his way around the life of the streets. One of his first major rackets was getting his schoolmates to pay him for protection (Lucky Luciano Biography, n.d.). If they didn’t cough up the money, he was liable to give them a beating himself (Lucky Luciano Biography, n.d.). By 1916, he was a leading member of the Five Points Gang, a gang with a reputation for brutality and for fighting to the death in gang wars. In this same year, Luciano started delivering narcotics for George Scanlon, and was caught for selling heroin, which got him a year at Hampton Farms Penitentiary. This was the start of something for Luciano. Luciano formed a gang that would later dominate the face of organized crime and change it into a new and all-pervasive menace that would influence the American social life for many years to come. He first met Meyer Lansky and Benjamin â€Å"Bugsy† Siegel when he was into â€Å"grabbing pennies† from jewish kids for protection (Gosch, 1975). Luciano had walked up to Lansky, and standing a whole head taller than him, made the usual proposition for protection (Gosch, 1975). Lansky stared Luciano down and, with no fear, told Luciano he didn’t need

My Eulogy Essay - 1065 Words

I remember how I went from excited to fearful in a matter of seconds. It was December. I was in the 4th grade, happy as I could be, innocent, but have had struggles in life as most kids with divorced parents have. We’ll start at school. That is where it all began. In class, we were making Christmas angel ornaments for our family. I was the only one, in my class of thirty that had divorced parents and decided to make one for each of my parents. I still remember that angel. That angel with messy glue marks, a crooked smile drawn with a black marker. My dad would still hang it on the tree after everything that had happened, saying every year â€Å"I remember when you gave this to me†, with a smile on his face. I’ve come to the†¦show more content†¦I ran up those four steps with such urgency and a big smile stretched across my face as I knocked on his door. I waited five seconds. No response. I knocked again. This time harder. It was odd that he wasn’ t answering. The apartment wasn’t that big and his car was parked in its spot. I was about to go back to the car and ask my mom if she knew where he was, when the apartment door suddenly yanked open. I thought I would I have been greeted with a smile with my unplanned, surprise arrival. I wasn’t. I was met with anger. Red hot, fiery, drunken rage. â€Å"Why are you knocking on my door so f***ing loud!† he yelled at me. Shock and panic were the only things in my mind as I said with trepidation, â€Å"I made a Christmas gift for you†¦and you didn’t answer†¦I’m sorry.† I didn’t notice I was crying until I felt the salty tears run down my face and touch my quivering lips. He went back inside to get his shoes I learned, I quickly wipe the tears off my face so he couldn’t see. I turned back to see where he was in the house, and all I see is my six foot one father barreling toward me. I take off running to the car, where my mom looked up, confused at why I was running. She looked behind me and saw what I was running from. My drunk father, who has made my life a struggle since I was born. â€Å"Why are you crying? What happened?† she asked in a concerned and worried tone. But she never had the chance to hearShow MoreRelatedMy Eulogy Essay903 Words   |  4 PagesMy brother is not just someone I share blood with but someone I can rely on and look up to. Patrick, my seventeen-year-old brother, has been by my side since I was a little baby. The earliest memories I have are of Patrick and I running around in our backyard laughing and playing. As he grew older, I began to look up to him. He was everything I aspired to be: intelligent, passionate, and athletic. Patrick always seemed to know what he wanted in life, and I admired how he chased down his goals. ThereRead MoreMy Eulogy Essay2027 Words   |  9 PagesSunday school that morning (I was too shy). My family was taking up the full row of chairs . 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Understanding the International Macro Economy

Question: Discuss about theUnderstanding the International Macro Economy. Answer: Introduction The most common decisive factor that is suggested by economists to determine the optimal exchange rate regime is macroeconomic as well as financial stability in the face of transient real or nominal shocks. The GCC was founded in the year 1981 with the objective of relinquishing closer ties as well as powerful links among the six member states. After the establishment of the GCC, member states signed a treaty that established the GCC Free Trade Area as well as delineated the steps for closer economic collaboration (Legrenzi 2015). The most common decisive factor suggested by theoretical literature for concluding the optimal regime of exchange rate is macroeconomic as well as economic stability in the face of real shocks. External stability is described as a balance of payments position that is not probable to lead to disruptive adjustments in the rates of exchange. The position of the balance of payment is reliable with external stability in which current account is widely in line wi th the level of equilibrium. The predictable view on the choice of regime of exchange rate is useful for macroeconomic as w,ell as financial constancy in the face of real domestic and external shocks. Fixed exchange rate is more effectual in accomplishing macroeconomic as well as financial constancy acting in response to domestic nominal shocks (Gervais, Schembri and Suchanek 2016). The weakness of oil prices led to questioning of the sustainability of the fixed rate of exchange currency systems in the GCC. There are several imperative causes to believe that low prices of energy could weaken the reliability of pegs in the region. Export revenues are mostly affected due to several oil-related goods that are considered as the major export of the Gulf countries. The foreign reserves of the central banks are likely to be drained due to the historically unrelenting current account surplus of the region that is also likely to put further pressure on the pegs (Arouri, Jouini and Nguyen 2013). Currencies mostly get prone to suffer exploratory attacks due to excess pressure on the regime of fixed rate of exchange. In this case, the exploratory attacks mostly include deflation as well as shift to a free-floating regime.The government of GCC has stated that they stay open to the choice of exchange rate arrangement under the proposed GCC currency union. Besides, several adv antages free-floating regime leads to several issues for Gulf countries. This is mostly due to the introduction of currency risks for cross-border business as well as expenditures. GCC currencies are likely to face additional pressure, as devaluation expectations are likely to generate considerable capital outflows. A balance of payment deficit of 14 percent and 21 percent are get experienced by both Saudi Arabia and Qatar respectively. This will mostly take place due to deterioration of the current account. Credibility of the fixed exchange rate mostly depends on the holdings of the foreign reserves. The largest volume of central bank reserves in the Gulf are acquired by Saudi Arabia both in absolute and comparative terms. This in turn helps to provide financial support to nine years of BoP deficit of its gross domestic product (Dell and Lawrence 2013). The rest of the GCC countries seem to appear in a meager position, if only the central bank reserves are taken into consideration. However, superior wealth fund resources are mostly not included in the reserves of central banks that could be used for monetary approach purposes. The fixed exchange regime are mostly guaranteed in the medium run due to adequate resources that are hold by authorities in the GCC countries. However, the evolution of oil prices in the long-run determines the adjustments of exchange rate (Ganguli 2016). Even Bahrain and Oman are able to endure comparatively long periods of low prices of oil as they could finance up to one year of imports with their national reserves as well as five years of a corresponding BoP deficit. The insulating properties of exchange rate regimes are affected powerfully by the structural characteristics of the GCC economies. As GCC countries may diversify in the future, flexibility of greater rate of exchange may be warranted. During t he year 2003, all the GCC countries (except Kuwait) were already pegged to the US dollar and the decision was made on the basis of the expectation that the dollar peg would maintain constancy and also reinforce confidence in the economies. GCC countries have pursued economic policies that are reliable with exchange rate pegs. Members of GCC have accumulated noteworthy foreign exchange reserves that strengthen the credibility of the peg and deject speculation against their currencies. Macroeconomic circumstance in the GCC countries has been steady for the last two decades mostly during the periods of dollar instabilities. The rate of exchange simplifies trade as well as economic transaction that lead to financial coordination among the member countries (Collins et al. 2017). Even in the absence of a well-developed domestic private market in forward exchange, risk related to exchange rate can be easily evaded as there remains a probability to work with the help of US dollar markets. W ith the given degree of variability of the GCC countries, it is tremendously difficult to conclude the rate of exchange without any impact on some of the stability characteristics. The predictable unit value of the projected GCC common currency is equal to 0.293 dollars. This rate of exchange is comparatively higher as compared to the existing currency exchange rates among the GCC countries. With cross-rates steady, intra-GCC business deal benefits as traders as well as investors do not have to take any risk that is associated with exchange rate. This in turn encourages further incorporation of members. GCC mostly considers the real exchange rate as a measure of competitiveness. The small model of GCC comprises of four equations for the real rate of exchange as well as real output and price level. The doubling-up of the real oil price appreciates the real rate of exchange of the GCC countries by about 3 percent on an average. Exchange rate arrangements other than the dollar peg could be considered in light of emerging changes in business as well as investment prototypes. With augmented mobility of capital, trade openness as well as foreign direct investment, the requirements for supporting an exchange rate peg become more challenging. The maintenance of a tight peg to the dollar forces the GCC countries to depend almost completely on fiscal policy in order to manage oil- related instability (Basher 2015). A more flexible regime of exchange rate is likely to provide these countries with another tool for adjust to oil shocks. However, the GCC countries also operate under large current account surpluses and as a result, their current exchange rate is undervalued. The dollar peg provides a powerful and easily understood anchor for monetary policy however; it is not possible to diverge too much from the rate of inflation of the US. Global competitiveness can be maintained under a fixed rate of exchange in the GCC countries due to flexibility of the labor market. The peg of the exchange rate also simplifies business as well as economic transaction. A single GCC currency float against other currencies would have the benefit of permitting the GCC countries to make the use of monetary policy in order to alleviate inflation and also non-oil productivity and to promote the expansion of the private non-oil economy. In the light of the present structural charact eristics of the GCC countries, the active monetary and exchange rate policies are put to question that whether these policies will be able to accomplish external stability (Bouoiyour and Selmi 2014). The risks that are associated with floating rates of exchange are the large swings in prices of oil that could lead to volatile rate of exchange and to larger fluctuation in non-oil productivity in the end. The implementation of basket peg may be helpful way in order to introduce several flexibility of the exchange rate. However, one of the disadvantages that are associated with basket peg is that it may diminish the microeconomic and informational advantages to maintain a constant two-sided rate of exchange. Gulf countries require to implement further long-term reforms in order to enhance the sustainability of their financial system and currency regime. Diversification is particularly requisite as it would shield the balance of payment from instability of oil price (Ghosh, Ostry and Qureshi 2015). (R) = ($) + (1 - )() Here R stands for the common currency of GCC. An optional to pegging to an individual currency, the dollar, is pegging to a basket of two currencies. However, and are constants in order to determine the nominal rate of exchange between R and the basket. In other words, the basket peg rule fixes the values of and . It can be concluded that the economies of GCC are identical in terms of their structural as well as financial fundamentals. The GCC states look identical in terms of sustainable expansion as well as price stability. It can be concluded the rate of exchange abridges trade as well as economic business that lead to financial organization among the member countries. At the exchange of GCC, real-time currency rates of exchange are provided. Due to weakness in the oil price, the sustainability of the fixed rate of exchange systems in the GCC is put to question. The currencies are mostly prone to undergo exploratory attacks mostly when fixed exchange rate are under pressure. It can concluded that the current rate of exchange for all the six countries of GCC are fixed except that of Kuwait and the exchange rate of those countries are comparatively higher than that of existing rates. References Arouri, M.E.H., Jouini, J. and Nguyen, D.K., 2013. On the relationship between world oil prices and GCC stock markets. Basher, S., 2015. Regional initiative in the Gulf Arab States: the search for a common currency.International Journal of Islamic and Middle Eastern Finance and Management,8(2), pp.185-202. Bouoiyour, J. and Selmi, R., 2014. GCC Countries and the Nexus between Exchange Rate and Oil Price: What wavelet decomposition reveals?.International Journal of Computational Economics and Econometrics,5(1), pp.55-70. Collins, R.D., Selin, N.E., de Weck, O.L. and Clark, W.C., 2017. Using inclusive wealth for policy evaluation: Application to electricity infrastructure planning in oil-exporting countries.Ecological Economics,133, pp.23-34. Dell, S. and Lawrence, R., 2013.The Balance of Payments Adjustment Process in Developing Countries: Pergamon Policy Studies on Socio-Economic Development. Elsevier. Ganguli, S., 2016. An economic analysis of sustainability of a potential GCC economic and monetary union during 2005-2014.World Journal of Entrepreneurship, Management and Sustainable Development,12(3), pp.194-206. Gervais, O., Schembri, L. and Suchanek, L., 2016. Current account dynamics, real exchange rate adjustment, and the exchange rate regime in emerging-market economies.Journal of Development Economics,119, pp.86-99. Ghosh, A.R., Ostry, J.D. and Qureshi, M.S., 2015. Exchange rate management and crisis susceptibility: A reassessment.IMF Economic Review,63(1), pp.238-276. Legrenzi, M., 2015.The GCC and the international relations of the Gulf: Diplomacy, security and economic coordination in a changing Middle East(Vol. 44). IB Tauris.